Wiki GEMs Question

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ltavolino

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If I am in a laboratory, can I, as a CPC, choose the correct ICD-10 code for a requisition form that only has a ICD-9 code listed? Can I use the GEMs tool to choose the correct ICD-10 diagnosis?

Thank you,
Lara
 
Code. Number in lieu of diagnosis

According to Coding Clinic 1Q 2012 pg 6:" is there an official policy or guideline requiring providers to record a written diagnosis in lieu of an ICD-9-CM code number?"

Yes, there are regulatory and accreditation directives that require providers to supply documentation in order to support code assignment...therefore it is not appropriate for providers to list the code number or select a code number from a list of codes in place of a written diagnostic statement."

CC 4Q 2013 pg 115 states:" coders should not use the GEMS to assign codes to medical records."

Hope this helps,
Shari, CPC-A
 
You cant code off GEMS. That's not what they were designed for. You will likely have to contact ordering physician and have them assign an ICD-10 code
 
If the code descriptions are consistent between i9 & i10, you are fine to make a translation. Although, as a rule, you cannot rely solely on the GEM tool. Outside of those relatively-few examples, you'll need to refer to the coding book and/or the physician for clarification/direction if necessary information is missing from the original lab order.
 
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